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Nicotine Patch May be Helpful in Mild Cognitive Impairment

Posted Jun 27 2009 11:00pm
From Geriatric Pharmacy Intern, Arathi Reddy, PharmD(c)
Palm Beach Atlantic University School of Pharmacy

The American Association of Geriatric Psychiatry held an annual meeting in 2009 and presented the results from a large, double blind, multi-center, pilot study which showed a link between nicotine replacement in elderly patients, and improved cognitive function. For many years, there has been research going on with the use of nicotine in different disorders to enhance cognitive function, including ADHD and dementia. The use of nicotine patches in this study improved attention, memory, and speed. This early study is proving that there truly may be a beneficial use for transdermal nicotine in mild cognitive impairment.
Mild Cognitive Impairment (MCI) is the transitional stage between the natural decline in cognitive function with normal aging and the more serious problems caused by dementia and Alzheimer’s. According to the American College of Physicians, MCI affects about 20 percent of the population over 70 and many continue to develop Alzheimer’s. The disorder affects many areas of thought and action, but the most common is memory problems.
Nicotinic receptor function is an important part of overall cholinergic activity. MCI patients make nicotine therapy and nicotinic agonists promising because these patients have not yet lost all of their nicotinic receptors. Therefore it is an ideal target to help improve cognition.
Nonetheless, the adverse effects of nicotine therapy also have to be taken into consideration, especially with regard to cardiovascular health. Although this study concluded that adverse reactions were mild and evenly split between the treatment group and the placebo group, larger studies need to be conducted to truly prove this. Significant decline in weight when comparing both arms of the study were the only side effects mentioned by the study authors.
If future studies do prove that transdermal nicotine is an appropriate treatment for MCI, then a new treatment that is safe, cheap, and effective may be introduced for elderly patients first diagnosed with MCI. As our population continues to age, finding ways to treat and limit the use of dementia medications for MCI and its progression to dementia, may be a crucial new advancement that can alleviate a lot of patient suffering and medication-related problems.
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